Abstract
Background: Neocosur is a collaborative international neonatal network created in 1997 to survey the outcome of VLBW infants in South America. Recognition of practices and outcomes variation among NICUs will allow participating centers to evaluate their performance and to select those interventions that may improve neonatal outcomes.
Aims: To describe clinical outcomes of VLBW infants admitted in 16 level III NICUs, from five South American Countries (Argentina-Chile-Paraguay-Peru-Uruguay) members of Neocosur.
Methods: All live infants with birth weight (BW) between 500 and 1500 g born in the participating centers were included. Biodemographic data and outcome measures were prospectively collected between 10/2000 and 05/ 2004. Data registration was made on line and analyzed by a central database unit.
Results: a total of 2,875 VLBW infants were included in the analysis. Mean BW was 1,085±279 g;, gestational age was 29 weeks ±3). Perinatal information was as follow: 80% of mothers received prenatal care; multiple gestation 18%; antenatal steroids 69%; prenatal antibiotics 36%; 65% of the infants were delivered by cesarean section; 51% were males, 15% had Apgar scores < 3 at 1 min and 7% had Apgar scores < 3 at 5 min. Global mortality was 22% with 4% dying in delivery room; congenital malformations were present in 11% of the cohort. Morbidity: 72% developed respiratory distress syndrome; 51% received surfactant therapy (41 % one dose and 43% two doses) and 65% received mechanical ventilation (mean duration = 4 days). Oxygen requirement at 28 days was 24% and 20% at 36 weeks' postmenstrual age. Cranial ultrasound was obtained in 92% and 31% had intracranial hemorrhages, G III -IV in 11%. Early onset sepsis was confirmed in 8% and late onset in 25%. NEC incidence was 11%. Retinal examinations were performed in 70% of patients and 30% had evidence of retinopathy of prematures. Mean length of stay was 60.7+28 days.
Conclusions: This international neonatal network represents the first model in South America using standardized definitions for coding data on line. This allows to analyze and compare clinical outcomes among centers and represents a new tool for improvements of the quality of neonatal care in the region.
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D'Apremont, I., Tapia, J. & Gederlini, A. 6 Vlbw Infants Outcome in a South American Neonatal Network for the Period 2000 - 2004. Pediatr Res 57, 921 (2005). https://doi.org/10.1203/00006450-200506000-00034
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DOI: https://doi.org/10.1203/00006450-200506000-00034